Comparative Study of Intermittent Auscultation and Continuous Electronic Monitoring of Labor in Low-Risk Pregnant Women in Four Hospitals in Douala (Cameroon)

Introduction: Monitoring fetal heart rate during labor allows for the early detection of anomalies and proactive intervention before complications arise. In our context, two types of monitoring are practiced: electronic and manual. However, electronic monitoring faces the challenge of the availability of cardiotocographs in operational-level healthcare facilities. A few intermediate-level healthcare structures are equipped with this tool. Objective: Our objective was to evaluate the impact of the type of labor monitoring on maternal and fetal outcomes in the maternity wards of Douala hospitals. Materials and Methods: We conducted a 5-month longitudinal observational study with an analytic component in 4 hospitals at different reference levels. The study exhaustively included parturients whose active labor phase was continuously monitored in these hospitals and whose fetuses were alive. Both the mothers and newborns were followed up to the second postpartum day. Statistical analyses were performed using SPSS software version 28.0. The chi-square test was used to compare quantitative variables, with a significance threshold set at p Results: During the study period, we recorded 498 deliveries, with 195 monitored by cardiotocography and 303 by fetal Doppler. The study population had an average age of 29.5 ± 5.8 years. All women were educated, and 53.4% had higher education levels. Multiparous women represented 47% of the study population, with an average parity of 1.4 ± 1.3. In total, 52% of the women had attended at least four prenatal consultations, and 75.5% were full-term. Regarding the mode of delivery, we found a cesarean rate of 21.5% for electronic monitoring compared to 6.2% for manual monitoring; 97.4% of women with pathological tracings underwent cesarean sections, compared to 100% of women with abnormal fetal heart rate patterns. The prevalence of neonatal asphyxia was 5.6% (11/195) in the electronic monitoring group and 6.3% (19/303) in the manual monitoring group. Three-quarters of neonatal deaths due to asphyxia occurred in the group that received manual monitoring. Conclusion: Although the rate of cesarean deliveries is higher with electronic monitoring, neonatal outcomes are better, with lower neonatal mortality, even though a higher rate of neonatal asphyxia was diagnosed compared to manual monitoring.